CASE NO.
DEPT. NO.
IN THE NINTH JUDICIAL DISTRICT COURT
OF THE STATE OF NEVADAIN AND FOR THE COUNTY OF DOUGLAS
In the Matter of the Application of:PETITIONER’S NAME,
For an Order Sealing Records. / PETITION TO SEAL RECORDS PURSUANT TO NRS 179.245 (CONVICTION)
COMES NOW, PETITIONER'S NAME, and petitions this Court for an Order pursuant to NRS 179.245 sealing the file and sealing all records concerning and in connection with the following convictions:
CONVICTION 1: CASE NUMBER
(If there is a District Court case number associated with the records you are trying to seal, please use that as the “Case Number,” if there is only a Justice Court case number, then use that number)
An arrest of petitioner on or about DATE OF ARRESTby the Douglas County Sheriff’s Department for the crime(s) of CHARGE, a CLASS OF CRIME, a violation of STATUTE OR COUNTY CODE.
- The Information filed on FILING DATEin the Ninth Judicial District Court Case No. DISTRICT COURT CASE NUMBER charged petitioner with CHARGE, a CLASS OF CRIME, a violation of STATUTE OR COUNTY CODE (Note: if the Information contains multiple charges, list each individually).
Or, if no Information was filed in District Court, - The charging document filed on FILING DATE in the TOWNSHIP NAME Justice Court Case No. JUSTICE COURT CASE NUMBER charged petitioner with CHARGE, a CLASS OF CRIME, a violation of STATUTE OR COUNTY CODE (Note: if the charging document contains multiple charges, list each individually).
On DATE, petitioner pled guilty to/was convicted of CHARGE, a CLASS OF CRIME, aviolation ofSTATUTE OR COUNTY CODE(if you were convicted of multiple offenses in this case, list each individually). All other charges were dismissed.
Petitioner requests that the following public and private agencies, companies, officials or other custodians of records who are reasonably known to Petitioner to have possession of his/her arrest be directed to seal their records:
(1) Douglas County Sheriff’s Department Case Number DCSO CASE NUMBER;
(2) Douglas County District Attorney’s Office Case Number DA CASE NUMBER;
(3) TOWNSHIP NAMEJustice Court Case Number JUSTICE COURT CASE NUMBER;
(4) Ninth Judicial District Court Case Number DISTRICT COURT CASE NUMBER; and
(5) Nevada Criminal History Repository.
CONVICTION 2: CASE NUMBER
(If you are only requesting to seal records pertaining to CONVICTION 1, you may delete this section. If you are requesting to seal records pertaining to multiple Convictions, please repeat these sections as many times as necessary.)
An arrest of petitioner on or about DATE OF ARRESTby the Douglas County Sheriff’s Department for the crime(s) of CHARGE, a CLASS OF CRIME, a violation of STATUTE OR COUNTY CODE.
- The Information filed on FILING DATEin the Ninth Judicial District Court Case No. DISTRICT COURT CASE NUMBER charged petitioner with CHARGE, a CLASS OF CRIME, a violation of STATUTE OR COUNTY CODE (Note: if the Information contains multiple charges, list each individually).
Or, if no Information was filed in District Court, - The charging document filed on FILING DATE in the TOWNSHIP NAME Justice Court Case No. JUSTICE COURT CASE NUMBER charged petitioner with CHARGE, a CLASS OF CRIME, a violation of STATUTE OR COUNTY CODE (Note: if the charging document contains multiple charges, list each individually).
On DATE, petitioner pled guilty to/was convicted of CHARGE, a CLASS OF CRIME, a violation of STATUTE OR COUNTY CODE. All other charges were dismissed.
Petitioner requests that the following public and private agencies, companies, officials or other custodians of records who are reasonably known to Petitioner to have possession of his/her arrest be directed to seal their records:
(1) Douglas County Sheriff’s Department Case Number DCSO CASE NUMBER;
(2) Douglas County District Attorney’s Office Case Number DA CASE NUMBER;
(3) TOWNSHIP NAMEJustice Court Case Number JUSTICE COURT CASE NUMBER;
(4) Ninth Judicial District Court Case Number DISTRICT COURT CASE NUMBER; and
(5) Nevada Criminal History Repository.
REQUEST TO SEAL
This petition is accompanied by a current, verified record of the criminal history of Petitioner received from the State of Nevada Criminal History Repository and the Douglas County Sheriff’s Department.
Petitioner submits that the records he/she seeks to seal include the incident reports and Records in the possession of the Douglas County Sheriff’s Department, the Douglas County District Attorney’s Office, the TOWNSHIP NAMETownship Justice Court, and the Ninth Judicial District Court, (add any other public or private agencies that have possession of the records). Petitioner respectfully requests the Court order the records sealed.
Petitioner requests that this matter be set for a hearing in due course.
DATED this _____ day of ______, 20__.
______
PETITIONER
CERTIFICATE OF SERVICE
I hereby certify, pursuant to NRCP 5(b), that I am the Petitioner herein, and that on this date I served counsel for the State of Nevada by □ mailing or □ hand-deliveringa true and correct copy of the Petition to Seal Records Pursuant to NRS 179.245 to the following addresses:
Douglas County District AttorneyP.O. Box 218
Minden, Nevada 89423
DATED this _____ day of ______, 20__.
______
PETITIONER
CASE NO.
DEPT. NO.
IN THE NINTH JUDICIAL DISTRICT COURT OF THE STATE OF NEVADA
IN AND FOR THE COUNTY OF DOUGLAS
IN THE MATTER OF THE APPLICATION OFPETITIONER'S NAME
FOR AN ORDER SEALING AND
EXPUNGING RECORDS.
______/ / ORDER SEALING RECORDS
(CONVICTION)
This matter came before this Court pursuant to a Petition to Seal Records of an arrest and Non-Opposition to Petition filed by the District Attorney’s Office, the Court finding the that the statutory requirements of NRS 179.245 are satisfied, and good cause appearing,
IT IS HEREBY ORDERED that the following records relating to the charges made against the petitioner and the records relating to the proceedings leading to the conviction be sealed in conformity with the provisions set forth in Nevada Revised Statutes:
CONVICTION 1: CASE NUMBER
(1) TOWNSHIP NAMEJustice Court Case Number JUSTICE COURT CASE NUMBERas it relates to the charges made against the petitioner by an agent of the Douglas County Sheriff’s Department onDATE OF ARREST, for the crime(s) ofCHARGE, a CLASS OF CRIME, a violation of STATUTE OR COUNTY CODE.
(2) Douglas County District Attorney’s Office file Number DA CASE NUMBERas it relates to the charges made against the petitioner by an agent of the Douglas County Sheriff’s Department on DATE OF ARREST, for the crimes ofCHARGE, a CLASS OF CRIME, a violation of STATUTE OR COUNTY CODE.
(3) Douglas County Sheriff’s Department Case Number DCSO CASE NUMBERas it relates to the charges made against the petitioner on DATE OF ARREST, by an agent of the Douglas County Sheriff’s Office for the crime(s) of CHARGE, a CLASS OF CRIME, a violation STATUTE OR COUNTY CODE.
(4) Ninth Judicial District Court Case Number DISTRICT COURT CASE NUMBERas it relates to the charges made against the petitioner on DATE OF ARREST, by an agent of the Douglas County Sheriff’s Office for the crime(s) of CHARGE, a CLASS OF CRIME, a violation of STATUTE OR COUNTY CODE.
CONVICTION 2: CASE NUMBER
(If you are only requesting to seal records pertaining to CONVICTION 1, you may delete this section. If you are requesting to seal records pertaining to multiple Convictions, please repeat these sections as many times as necessary.)
(1) TOWNSHIP NAMEJustice Court Case Number JUSTICE COURT CASE NUMBERas it relates to the charges made against the petitioner by an agent of the Douglas County Sheriff’s Department onDATE OF ARREST, for the crime(s) ofCHARGE, a CLASS OF CRIME, a violation of STATUTE OR COUNTY CODE.
(2) Douglas County District Attorney’s Office file Number DA CASE NUMBERas it relates to the charges made against the petitioner by an agent of the Douglas County Sheriff’s Department on DATE OF ARREST, for the crimes ofCHARGE, a CLASS OF CRIME, a violation of STATUTE OR COUNTY CODE.
(3) Douglas County Sheriff’s Department Case Number DCSO CASE NUMBERas it relates to the charges made against the petitioner on DATE OF ARREST, by an agent of the Douglas County Sheriff’s Office for the crime(s) of CHARGE, a CLASS OF CRIME, a violation STATUTE OR COUNTY CODE.
(4) Ninth Judicial District Court Case Number DISTRICT COURT CASE NUMBERas it relates to the charges made against the petitioner on DATE OF ARREST, by an agent of the Douglas County Sheriff’s Office for the crime(s) of CHARGE, a CLASS OF CRIME, a violation of STATUTE OR COUNTY CODE.
IT IS HEREBY FURTHER ORDERED that a copy of this Order shall be sent by Petitioner, pursuant to NRS 179.275, to each public or private agency, company, official named herein as well as the Nevada Department of Public Safety, Records and Technology Division. The persons, agencies, companies, officials or custodians named in this order shall seal the records delineated herein and shall advise the Court of his/her/their compliance, and shall then seal the Order.
Pursuant to NRS 179.285(1), all proceedings recounted in the sealed records are deemed never to have occurred, subject to the provisions set forth in NRS 179.295, and the petitioner may properly answer accordingly to any inquiry, including, without limitation, an inquiry relating to an application for employment, concerning the arrest, conviction, dismissal or acquittal and the events and proceedings relating to the arrest, conviction, dismissal or acquittal.
IT IS FURTHER ORDERED pursuant to NRS 179.285(2) that the civil rights of the petitioner be restored in connection with the charges in the criminal matter(s) which is/are the subject of this civil petition for sealing of records, including the right to vote, the right to hold office, and the right to serve on a jury. The order for restoration of civil rights does not restore the petitioner’s civil rights in any other cases in any other court, jurisdiction or state wherein the civil rights have not been restored therein.
DATED this _____ day of ______, 20__.
______
DISTRICT JUDGE